THE BREAKTHROUGH COACHING MDP PRACTICE™

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The decision to establish an MDP practice is beneficial to practices that have achieved a measure of success and are looking to take their business to the next level. It does not diminish or tarnish the basic tenets of chiropractic philosophy in any way. The addition of a multidisciplinary model requires several preliminary steps starting with the recruiting of medical personnel, as well as the creation of a proper corporate structure. This is necessary because, in many states, chiropractors are not permitted to own medical practices.

The following is an outline of how Breakthrough Coaching assists its members in the establishment of multidisciplinary practices:

A. Advise on the recruitment of medical personnel
B. Assist your attorney in the creation & filing of the appropriate corporate structure
C. Training each respective department and discipline

D. Assist with interprofessional communications
1. Accountant
2. Attorney
3. Professional Staff
4. Financial Planner

E. Advise on the purchase of supplies and equipment
F. Capitalization needs for changeover and monthly operating expenses
G. Administrative protocols for operating the MDP
H. Advise on proper billing and additional coding procedures in the MDP
I. Advise on delegation of responsibilities and job functions
J. Scripting For Each Department
K. Transferring patients from chiropractic to the Multidisciplinary Practice
L. Advise on marketing and new patient acquisition for the MDP
M. Develop relationships with community based physicians
N. Creation and development of quality assurance & compliance program
O. Running an ethical practice by adhering to Breakthrough Coaching standards

ACA Issues Official Policy Statement on Multi-Discipline Practices (MDP)

With respect to providing education to both the chiropractic and insurance professions, the ACA established a Fraud Sub-Committee under the Insurance and Managed Care Committee to research and provide commentary on this topic and others. This committee included doctors in private practice from across the country, chiropractic leadership, insurance industry representatives, legal counsel, and consultants, including Mark Sanna, DC, FICC, CEO of Breakthrough Coaching, who have experience in this field.

The Official ACA MDP Policy Statement was presented to the House of Delegates who passed the resolution at the March 2005 National Chiropractic Legislative Conference (NCLC) in Washington, DC. This is the first such initiative of its kind and Breakthrough Coaching is proud to have played a role in its development. We encourage all Breakthrough Coaching Members, as well as non-Members, who participate in an MDP to download a copy of the complete policy statement and to make it a component of their OIG Compliance Manual.

Confronted by the remarkable growth of multi-disciplinary health care clinics across the country you may find yourself, like many chiropractors, wrestling with the decision of whether or not multi-disciplinary practice is right for you. Chiropractors across the country are sharing the painful experience of having to scale back their lifestyle due to the decrease in the revenue their practices are generating. Market forces are also driving a trend toward practice consolidation. This trend has been well established in the medical community where less than thirty percent of medical doctors remain in private practice. It will soon be the case that it will be equally rare for a chiropractor to practice independently outside of a group chiropractic or multi-disciplinary setting.

This trend of "safety in numbers" shows no sign of letting up as chiropractors embrace the economic reality that demands and rewards the diversification of the services they provide to their patients. The multi-disciplinary practice has its structure set firmly upon the foundation of marketplace efficiency and patient satisfaction. The answer to the question of whether multi-disciplinary practice is right for you can be answered yes, if it is a practice that is operated with integrity and based upon ethical principles. It is indeed possible for you to create a subluxation-based multi-disciplinary practice that honors the art, science and philosophy of the chiropractic profession.

It is time for healthcare practitioners of all disciplines to make their services more accessible to patients in one-stop holistic/allopathic blended health care practices that honor the disciplines of all of the practice members involved. Multi-disciplinary practices that provide both allopathic and holistic therapies are able to deliver care with a two-pronged "corrective" and "preventive" approach. The DC-managed multi-disciplinary clinic is the best-equipped model to bring to the market that which the public is demanding.

A multi-disciplinary practice in not a method to change your chiropractic practice into a medical practice with a few legal slights of hand. It is not a method of increasing your reimbursement revenues by misrepresenting your chiropractic services as medical, nor is it a method of fraudulently obtaining insurance coverage for your chiropractic treatment that would otherwise not be covered. Your multi-disciplinary practice should be created for the benefit of your patients. Your multi-disciplinary practice will offer your patients a much broader scope of services than those available in either a medical or chiropractic practice alone. It will also deliver these services in a more efficient and cost-effective manner.

When you operate your practice correctly, legally, and with proper professional guidance, adopting a multi-disciplinary model will grow your practice considerably. Your increased scope of services will attract more new patients and will result in a larger patient volume. Your multi-disciplinary practice will also possess increased access to the healthcare market. While only approximately 10 percent of the population seeks chiropractic care, the majority of the population goes to medical practices. Creating a multi-disciplinary practice provides you with the opportunity to offer chiropractic care to a larger segment of the population, many of whom may never have sought out chiropractic otherwise. This expanded access alone will significantly increase the volume of patients and services rendered in your practice.

As the requirement for objective documentation grows, diagnostic testing is given an expanded role in the multi-disciplinary environment. Chiropractic has traditionally placed a greater emphasis on treatment over diagnostic testing. It is frustrating for chiropractors to be repeatedly denied reimbursement due to inadequate documentation and the claim by insurance carriers of a lack of medical necessity. Your multi-disciplinary practice will bring together the resources and the technology required to objectively document the necessity of care without having to overcome the special hurdles that have been selectively placed in the path of the chiropractic profession.

While multi-disciplinary clinics are enjoying great popularity among the general public, a few high profile practices have found themselves in the investigative limelight due to their questionable business practices. Their professional corner-cutting and unabashed greed have created an environment of distrust for the model among chiropractors who tend to generalize their unscrupulousness to all multi-disciplinary practices.

A word to the wise, it is vitally important that you obtain very sound legal and management advice when undertaking the conversion of your practice to the multi-disciplinary model. There are more laws, regulations, guidelines and protocols involved in operating in this arena. Retaining the services of an attorney and management consultant who are familiar with the legal and business structures of the multi-disciplinary practice is an investment that will save you time, trouble and dollars in the long run.

As a chiropractor you possesses the ability to deliver an incredible healing modality, the chiropractic adjustment. Unfortunately, the general public not recognized and embraced chiropractic as the valuable healing modality that it is. Chiropractors have been attempting to change the healthcare system from the "outside in" for over a century. Now is the time for you to heed your own philosophy and realized that health comes from the "inside out." Converting your practice to a multi-disciplinary facility is a way for you to insure that the profession of chiropractic is robust and thriving for future generations to come.

Breakthrough Coaching recommends that you consult a local attorney experienced in MDP Practice™ for the appropriate legal structure.